Prognostic value of metabolic parameters measured by first responders attending patients with severe trauma: associations with the New Injury Severity Score and mortality.

Objectives: Patients with severe or potentially severe trauma must be identified early, a challenge in prehospital settings. This study aimed to analyze the possible diagnostic and prognostic usefulness of analytical markers recorded in the early moments of care.

Material And Methods: Observational study of information extracted from the prospective multicenter Code Trauma database for 2016-2019, excluding data for isolated head injuries.

Loss of mitochondrial membrane potential (ΔΨ ) in leucocytes as post-COVID-19 sequelae.

The mitochondrial membrane potential (ΔΨ ) is a parameter often used to determine mitochondrial function; therefore, it can be used to determine the integrity and functionality of cells. A decrement of ΔΨ is implicated in several inflammatory-related pathologies, such phenomena can be related to COVID-19 infection. The present work aimed to compare the ΔΨ in leucocytes (human PBMCs; HPBMC) isolated from healthy control (HC) subjects, patients with COVID-19 (C-19), recovered subjects at 40 ± 13 (R1) and 335 ± 20 (R2) days after infection (dai).

Effect of Fucoidan on the Mitochondrial Membrane Potential (ΔΨm) of Leukocytes from Patients with Active COVID-19 and Subjects That Recovered from SARS-CoV-2 Infection.

Fucoidan is a polysaccharide obtained from marine brown algae, with anti-inflammatory, anti-viral, and immune-enhancing properties, thus, fucoidan may be used as an alternative treatment (complementary to prescribed medical therapy) for COVID-19 recovery. This work aimed to determine the ex-vivo effects of treatment with fucoidan (20 µg/mL) on mitochondrial membrane potential (ΔΨm, using a cationic cyanine dye, 3,3'-dihexyloxacarbocyanine iodide (DiOC(3)) on human peripheral blood mononuclear cells (HPBMC) isolated from healthy control (HC) subjects, COVID-19 patients (C-19), and subjects that recently recovered from COVID-19 (R1, 40 ± 13 days after infection). In addition, ex-vivo treatment with fucoidan (20 and 50 µg/mL) was evaluated on ΔΨm loss induced by carbonyl cyanide 3-chlorophenylhydrazone (CCCP, 150 µM) in HPBMC isolated from healthy subjects (H) and recovered subjects at 11 months post-COVID-19 (R2, 335 ± 20 days after infection).

Multidisciplinary consensus on cancer management during pregnancy.

Cancer during pregnancy is a challenge for multi- and interdisciplinary collaboration due to the diagnostic, prognostic and therapeutic implications, the need for an integrated harmonization of medical action for the pregnant patient and the embryo or foetus and the characteristics of each gestational period, which will determine the protocol to be proposed and its limitations. For this reason, a group of experts appointed by participating scientific societies, which includes the Spanish Society of Medical Oncology (Sociedad Española de Oncología Médica-SEOM), the Spanish Association of Surgeons (Asociación Española de Cirujanos-AEC), the Spanish Society of Gynaecology and Obstetrics (Sociedad Española de Ginecología y Obstetricia-SEGO), the Spanish Society of Nuclear Medicine and Molecular Imaging (Sociedad Española de Medicina Nuclear e Imagen Molecular-SEMNIM), the Spanish Society of Oncological Radiotherapy (Sociedad Española de Oncología Radioterápica-SEOR) and the Spanish Society of Medical Radiology (Sociedad Española de Radiología Médica-SERAM), have worked together to establish consensus recommendations that allow the harmonization of management and ultimately the optimization of the healthcare of pregnant patients with cancer. When cancer is detected in a pregnant woman, the week of gestation in which the diagnosis is made must be considered, as well as the characteristics of the tumour.

Teaching courses in the management of visceral trauma.

Several changes introduced in the management of trauma during the last two decades have considerably decreased the practical exposure to bleeding trauma patients by residents and young surgeons. Hemorrhage still represents the second cause of death from trauma worldwide, and the surgical maneuvers required for its control must be learned and practised in specific courses. These courses address the "second hour" of trauma, beyond ATLS, and also emphasize the decision-making process, communication among team members, and discussion of clinical scenarios.

Changes in microbial dynamics during vermicomposting of fresh and composted sewage sludge.

Municipal sewage sludge is a waste with high organic load generated in large quantities that can be treated by biodegradation techniques to reduce its risk to the environment. This research studies vermicomposting and vermicomposting after composting of sewage sludge with the earthworm specie Eisenia andrei. In order to determine the effect that earthworms cause on the microbial dynamics depending on the treatment, the structure and activity of the microbial community was assessed using phospholipid fatty acid analysis and enzyme activities, during 112days of vermicomposting of fresh and composted sewage sludge, with and without earthworms.

Trap-door incision for penetrating thoracic trauma: an obsolete approach?

Penetrating injuries to the subclavian vessels are uncommon and very severe lesions. They are difficult to expose and carry a high mortality. "Trap-door" incisions have lately been dismissed as too mutilating for the occasional victim of a penetrating thoracic trauma with massive bleeding difficult that is to expose.

Abdominal blast injuries: different patterns, severity, management, and prognosis according to the main mechanism of injury.

Purpose: To review the frequency, different patterns, anatomic severity, management, and prognosis of abdominal injuries in survivors of explosions, according to the main mechanism of injury.

Methods: A MEDLINE search was conducted from January 1982 to August 2013, including the following MeSH terms: blast injuries, abdominal injuries. EMBASE was also searched, with the same entries.

[Intussusception in the adult: a rare cause of mechanical obstruction].

Intussusception is an infrequent cause of mechanical intestinal obstruction in the adult. We present herein two clinical cases of intussusception with different etiologies. In the first case, the underlying cause was a lipoma, and in the second, it was metastasis from melanoma.

[Esopheal foreign body impaction].

Esophageal ingestion of foreign bodies is a frequent urgency. It occurs more commonly in patients with psychiatric disorders, prisoners and extreme ages of the life. Early upper endoscopy is the method of choice for the treatment of symptomatic patients.

[Gastrointestinal and mesenteric injuries in the trauma patient: incidence, diagnosis delay and prognosis].

Background: Gastrointestinal and mesenteric injuries (GIMI) are uncommon in trauma patients, and their diagnosis are often delayed. Our aims were to determine the reliability of CT scan in our centre, and to assess the clinical significance of a delayed diagnosis.

Materials And Method: Retrospective analysis of cases confirmed at laparotomy.

Overall Asessment of the Response to Terrorist Bombings in Trains, Madrid, 11 March 2004.

Objectives: To provide an overall assessment of the response to the terrorist bombings in Madrid, 11 March 2004, which were considered the deadliest terrorist attack on European soil in modern times.

Materials And Methods: Overall data on the number of victims treated at the scenes and at primary care facilities and hospitals, as well as the logistics involved, were reported by the EMS and the Health Authority of the Comunidad de Madrid local government. Data were mainly obtained by retrospective chart review, and did not include casualties who had only emotional shock, superficial bruises or transient hearing loss from barotraumas without eardrum perforation.

Injury patterns from major urban terrorist bombings in trains: the Madrid experience.

Background: Terrorist urban mass casualty incidents (MCI) in the last 3 years have targeted commuter trains at rush hour, producing large numbers of casualties. Civilian care providers are usually not familiar with the types of blast injuries sustained by victims of these MCI.

Methods: We focus on the injury patterns sustained by casualties of the Madrid, 11 March 2004, terrorist bombings, at the seven hospitals that received most victims.

[Severe pelvic fractures, associated injuries and hemodynamic instability: incidence, management and outcome in our center].

Introduction: The aim of this study was to review the incidence, treatment and outcome of severe pelvic fractures, as well as associated injuries, in our center.

Patients And Method: We performed a retrospective study of patients included in our trauma registry between June 1993 and January 2005. Pelvic fractures were classified according to the system proposed by Tile.

[Use of the round ligament in the repair of large bile duct defects in type II Mirizzi's syndrome].

Mirizzi's syndrome is a rare complication of cholelithiasis, and type II (cholecystocholedochal fistula) can be a technical challenge due to inflammation and the biliary duct defect. We report two cases that were treated with a simple and little known technique that uses the round ligament as a plasty to seal the large bile duct defect.

[General surgery].

Terrorist explosions with multiple victims produce disaster situations that test health systems' ability to respond. The Gregorio Maranon University Hospital attended more than 300 victims within a few hours. Most of these victims had mild or moderate lesions, although 29 patients arrived in a serious or critical condition.

11 March 2004: The terrorist bomb explosions in Madrid, Spain--an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital.

At 07:39 on 11 March 2004, 10 terrorist bomb explosions occurred almost simultaneously in four commuter trains in Madrid, Spain, killing 177 people instantly and injuring more than 2000. There were 14 subsequent in-hospital deaths, bringing the ultimate death toll to 191. This report describes the organization of clinical management and patterns of injuries in casualties who were taken to the closest hospital, with an emphasis on the critically ill.

Casualties treated at the closest hospital in the Madrid, March 11, terrorist bombings.

Background: At 07:39 am on March 11th, 2004, ten terrorist bomb explosions occurred almost simultaneously in four commuter trains in Madrid, Spain, killing instantly 177 people and injuring >2,000. There were 14 subsequent in-hospital deaths, bringing the definite death toll to 191 victims. This article describes the organization of the clinical management and patterns of injuries in casualties who were taken to the closest hospital, with emphasis on the critical patient population.

Adhesive small bowel obstruction: predictive value of oral contrast administration on the need for surgery.

Introduction: adhesive small bowel obstruction (SBO) is a common cause of hospital admission. Nonoperative management is initially recommended unless there is suspicion of strangulation, but its optimal duration is controversial. The aims of our study was to evaluate the usefulness of radiographic small bowel examination with contrast medium to predict the need for surgery in SBO.

Early resolution of Ogilvie's syndrome with intravenous neostigmine: a simple, effective treatment.

Purpose: Our aim was to assess the value of a parasympathomimetic drug (neostigmine) in the early resolution of acute colonic pseudo-obstruction (Ogilvie's syndrome).

Methods: A prospective study was undertaken in 18 consecutive patients (mean age, 76 (range, 31-87) years) with acute colonic pseudo-obstruction. After a varying period of conservative treatment in all cases, 16 patients with persistent, massive abdominal distention were given intravenous neostigmine.

[Acute obstruction of the colon secondary to biliary lithiasis].

Gallstone ileus is an unusual cause of mechanical obstruction of the gastrointestinal tract; but obstruction of the colon by a gallstone is an even more rare event, and there are few references in the literature. We describe the cases of two elderly women who were admitted to the Emergency Service with a mechanical obstruction of the colon and air in the biliary tract. A barium-enema examination showed the presence of a foreign body in the sigmoid colon; this was found to be a gallstone in a subsequent colonoscopy in one of the patients; a precise preoperative diagnosis was not possible in the other.